Meclam

Indications

Meloxicam is a non-steroidal anti-inflammatory drug (NSAID). It is used to relieve pain, swelling and stiffness in osteoarthritis (wear-and-tear arthritis), rheumatoid arthritis and ankylosing spondylitis (inflammatory arthritis of the spine). Doctors may also use it for other painful inflammatory conditions of muscles and joints.

How It Works

Meloxicam blocks enzymes called cyclo-oxygenases (mainly COX-2), which the body uses to make prostaglandins. Prostaglandins cause pain, swelling and redness at sites of inflammation. Lowering them eases pain and inflammation. It does not cure arthritis but helps control symptoms.

Dosage and Administration

The usual adult dose is 7.5 mg once a day, which the doctor may increase to 15 mg once a day if needed. Do not take more than 15 mg a day. People at higher risk of side effects, such as older people and those on dialysis, usually take 7.5 mg. Take it with or after food and a glass of water. Use the lowest dose that works for the shortest time. Injection forms are given by a doctor or nurse. Children: only as prescribed.

Interactions

Taking meloxicam with other NSAIDs or Aspirin increases the risk of stomach bleeding. Blood thinners such as Warfarin, steroids such as Prednisolone and SSRI antidepressants also raise bleeding risk. It can reduce the effect of blood pressure medicines (ACE inhibitors, ARBs, diuretics) and, with them, may harm the kidneys. It can raise levels of Lithium and Methotrexate. Avoid alcohol.

Contraindications

Do not use meloxicam if you are allergic to it, or if Aspirin or other NSAIDs have caused asthma, hives or swelling; if you have an active stomach ulcer or bleeding, severe heart failure, severe liver or kidney disease, bleeding problems; just before or after heart bypass surgery; or in the last 3 months of pregnancy.

Side Effects

Common side effects include indigestion, stomach pain, nausea, diarrhoea, wind, headache and dizziness. Less common effects include fluid retention, swelling of the ankles, raised blood pressure, rash and changes in kidney or liver tests. NSAIDs can cause stomach ulcers and bleeding, and increase the risk of heart attack and stroke, especially with high doses or long use.

Get urgent medical help if you vomit blood or pass black or bloody stools, have severe stomach pain, chest pain, sudden weakness on one side or trouble speaking, shortness of breath, a blistering or peeling skin rash, yellow skin or eyes, or swelling of the face and throat.

Pregnancy and Lactation

Avoid meloxicam in pregnancy unless a doctor advises it, especially from 20 weeks onward, as it can affect the baby's kidneys and heart; it must not be used in the last 3 months. NSAIDs may also make it harder to become pregnant. It is not recommended while breastfeeding; ask your doctor about safer options.

Precautions and Warnings

Use with care if you have had stomach ulcers, heart disease, high blood pressure, kidney or liver problems, asthma, or are older. Your doctor may check blood pressure, kidney function and blood counts during long-term use. Stop and seek advice if you get signs of stomach bleeding. It may cause dizziness, so take care when driving.

Overdose

Overdose can cause stomach pain, nausea, vomiting, drowsiness and, in severe cases, stomach bleeding, kidney failure, breathing problems or fits. Seek medical help straight away.

Therapeutic Class

Non-steroidal anti-inflammatory drug (NSAID), oxicam group, preferential COX-2 inhibitor.

Storage

Store below 30°C in a dry place, away from light and out of the reach of children. Injections are stored as directed on the pack.